Effectiveness of oral health interventions for schoolchildren from disadvantaged backgrounds: a systematic review protocol.

Disadvantaged schoolchildren from rural and low socioeconomic backgrounds face persistent oral health inequalities, specifically dental caries, and periodontal diseases. This protocol aims to review the effectiveness of promotive and preventive oral health interventions for improving the oral health of primary schoolchildren in these areas. We will search the PubMed, MEDLINE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCOhost, Cochrane Library, Web of Science, Dentistry and Oral Sciences databases for studies published from 2000-2023. The review includes randomised/nonrandomised controlled trials and community trials evaluating the effectiveness of promotive and preventive oral health interventions on at least one of these outcomes: changes in dental caries status, periodontal disease status, oral hygiene status/practices, sugar consumption, or smoking behaviours. Two reviewers will independently assess the searched articles, extract the data, and assess the risk of bias in the studies using the Cochrane Risk of Bias 2 (ROB 2) for randomised controlled trials and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) for non-randomised controlled trials. Both narrative and quantitative analyses will be conducted. However, only narrative synthesis will be performed if the data are substantially heterogeneous. The synthesised evidence from this review can inform policymakers on evidence-based interventions to improve the oral health outcomes of schoolchildren from rural and low socioeconomic backgrounds. Systematic Review Registration PROSPERO (Registration number: CRD42022344898).

The influence of parental oral health literacy on children's oral health: a scoping review.

The aim of this review was to evaluate the association between parental oral health literacy and children's oral health outcomes. A comprehensive search was conducted across four electronic databases to identify articles that were published up to October 2023. The articles that met our predetermined criteria were then screened and assessed for eligibility. Updated Arksey and O'Malley's scoping review framework was followed. After identifying 2964 references, duplicates were removed, leaving 1992 titles. Following the screening of article titles and abstracts, 19 full-text articles underwent a thorough examination. The scoping review included 19 relevant studies. In most of the studies included, the status of oral health of children is linked to the caregiver's oral health literacy. Children of caregivers with low oral health literacy were found to exhibit deleterious oral health habits, including inadequate teeth brushing and the use of bottles at night-time. Dental caries was found to be more common in children whose parents had low oral health literacy. Striving for optimal oral health literacy in the community is a valuable and worthwhile effort. Equipping parents with the skills and knowledge to make appropriate decisions about their children's oral health could positively prevent dental caries and promote better oral health outcomes.

The effect of socio-economic status on children's dental health.

The aim of the present study was to record the oral health status of children from different socioeconomic backgrounds and correlate these findings with parent-associated factors. It comprised a cross-sectional study of healthy children, aged 6-12 years, attending either the Reception and Solidarity Center of the Municipality of Athens or the Postgraduate Paediatric Dentistry Department (NKUA) for dental care. Data regarding the demographics of both parents-guardians, as well as the children, and oral hygiene and dietary habits were collected through a structured questionnaire. This was followed by a thorough clinical examination evaluating oral hygiene status, gingival inflammation and caries experience. Analysis was based on the socioeconomic status (SES) of the parents which was according to the family income. Families with a monthly income of <1400 euros were considered as being of a low SES and families with incomes of >1400 euros as medium. Data were presented in frequency tables and significance of calculated differences was tested using chi-square and Fisher's exact tests. Multivariate regression analysis was used to detect possible risk factors for development of poor dental health. The sample consisted of 216 children (146 from a low and 70 from a medium SES) with a mean chronological age of 9.19 years. Parents from low SES were younger, of lower education, had lived abroad most of their lives and were unemployed or worked in the private sector. Children from low SES backgrounds reported infrequent dental visits, consumed more meals and had more sugary snacks. This was reflected in their worse dental health with significantly higher values for oral hygiene and caries indices. Despite the above differences, none of the parent-associated factors were significantly correlated to worse dental health. In conclusion, SES of parents is reflected in the oral health of children, although it is not a significant predictor of dental health.

Black stain and dental caries in primary dentition of preschool children in Qingdao, China.

Black stain (BS) and caries are common oral issues in children worldwide. This study aimed to reveal the prevalence of BS and caries in primary dentition of children in Qingdao, China and evaluate the potential association between them. A total of 672 preschool children aged 3-5 years old from 12 kindergartens in Qingdao, northern China were enrolled in the study. The prevalences of BS and caries were counted, and their distributions across different ages and genders were analyzed. The potential protective role of BS (independent variable) on caries (dependent variable) was analyzed via binary logistic regression analysis. BS was observed in 103 children (15.33%), including 3 severe- (0.45%), 28 moderate- (4.17%), and 72 mild (10.71%) forms. Caries was observed in 374 children (55.65%) and it was positively associated with age. Notably, the prevalence of caries was lower in children with BS than in those without BS (42.72% vs. 58.00%, respectively). Children with BS were less likely to suffer from caries than those without BS. BS in mild or moderate/severe forms was associated with a low risk of caries. In summary, the prevalence of BS in primary dentition in Qingdao, China is at a relatively high level worldwide. BS is a protective factor for caries in primary dentition.

Bulk-flow composites in paediatric dentistry: long term survival of posterior restorations. A retrospective study.

Dental decay is a prevalent bacterial disease affecting a significant percentage of children globally. In paediatric dentistry, various materials are available for restoring deciduous teeth, addressing both functional and aesthetic concerns. However, paediatric dentists encounter challenges related to patient compliance, limited working time, and material handling. This study aims to observe the survival rate of bulk-fill composite restorations in paediatric patients over a five-year follow-up. A total of 198 patients aged 0 to 12 years underwent 673 class II restorations on deciduous first molars (1M) and second molars (2M). All restorations were conducted performed by 1 Pediatric DDS resident students from the Paediatric Dentistry Department (Padova University), utilizing using different isolation techniques. Bulk-fill composite restorations were evaluated over a five-year follow-up, and data were collected by a single investigator. After five years, 177 patients and 611 restorations were assessed. The retention rate was higher in primary second molars than in first molars, with fewer marginal dyschromies and less formation of secondary caries. The overall failure rate was higher in primary first molars and primary lower second molars. Bulk-fill composites demonstrated significantly positive performance in terms of retention, maintenance, and marginal dyschromies. Bulk-fill composites are promising materials of choice in paediatric dentistry due to their easy handling and favorable properties. Further research is necessary to compare high and low viscosity bulk-fill composites and assess the impact of different variables on restoration success.

Clinical evaluation of hydrophilic and hydrophobic resin-based sealants in uncooperative children: a randomized controlled clinical trial.

This clinical trial aimed to evaluate and compare the retention and cariostatic effects of hydrophilic and hydrophobic resin-based sealants (RBSs) for sealing pits and fissures in the permanent molars of uncooperative children. A split-mouth and double-blind randomized clinical trial (RCT) was conducted among 6- to 9-year-old uncooperative children. One hundred and four sound mandibular and maxillary first permanent molars were randomly allocated to be sealed with group I (UltraSeal XT® hydro™) or group II (Helioseal-F) in 34 uncooperative children. Clinical evaluation was performed by two investigators using the Color, Coverage and Caries system to assess sealant retention and cariostatic effect at 3-, 6- and 12-month intervals. Data analysis was performed using Friedman's and Mann-Whitney U tests. The final analysis included 31 children with 49 pairs of teeth. No significant differences were observed between the retention and cariostatic effects of hydrophilic and hydrophobic RBSs at the 3-, 6- and 12-month intervals (p = 0.23, p = 0.638, and p = 0.706, respectively) (p = 0.175, p = 0.065, and p = 0.171, respectively). After 12 months of follow-up, the hydrophilic RBSs showed an outcome equivalent to that of conventional hydrophobic RBSs in terms of retention and cariostatic effects. Therefore, hydrophilic RBSs could be considered as the sealing material of choice when isolation is difficult, particularly in uncooperative children.

Are we adequately managing the oral health needs of children: a survey of the experience of general dentists and self-assessed confidence in pediatric dentistry.

Childhood caries is a public health problem with a significant burden on the community. The specialist dental workforce cannot adequately manage all treatment needs in children. Therefore, the general dental community remains critical in delivering care to children. The purpose of this study was to investigate the self-rated confidence of general practitioners in treating children. A cross-sectional survey was designed that involved general dentists in various primary care centers in Jordan. Participants were asked to complete a questionnaire about their experience and self-perceived level of confidence in performing various procedures in children using the Likert scale. Descriptive statistics, t-tests and one-way analysis of variance (ANOVA) were used for data analysis. A total of 150 general dentists completed the questionnaire. The overall confidence score was high (3/4). Most respondents (86.7%) reported high confidence in providing prophylaxis and preventive treatment. The lowest level of confidence was reported for dental trauma and interceptive orthodontics. No statistically significant gender disparity was found except for the management of dental trauma in which males were significantly more confident than females. Regarding years of experience, confidence levels in dental trauma management were significantly higher among dentists with 5-10 years of experience compared to the recently graduated and the longest qualified dentists (p = 0.008). Similarly, for interceptive orthodontics, participants with 5-10 years of practice were significantly more confident compared to dentists in the other groups (p = 0.021). One-third of participants (30.1%) were not willing to treat children and considered them disruptive to their practice. Overall, This study revealed low levels of confidence in dental trauma management and interceptive orthodontics in children. Modification of dental curricula to increase clinical exposure should positively reflect on future levels of confidence. Strategies should be implemented to encourage general dentists to treat children to ensure equitable access for all.

Management of oblique root fracture in the middle third of two maxillary immature central incisors with severe caries in mixed dentitions: a case report.

Mid-root fractures are rare injuries in young permanent teeth and tend to have poor prognoses. This study presents a case of oblique root fracture of both maxillary immature central incisors in the middle third accompanied by delayed dental visit and severe caries of all primary teeth. After restoring all the primary and permanent teeth that needed stabilization, the coronal fragments were repositioned and stabilized with a flexible splint consisting of orthodontic wire and composite resin. A comprehensive and sequential dental treatment for other oral diseases and oral hygiene instructions were provided. A 16-month follow-up revealed that the two injured young permanent incisors were healed, surrounded by hard tissues and continued to grow both in length of the root and thickness of the root canal wall, with significant improvement in oral hygiene. Based on the outcome of this case, initial stabilization without endodontic therapy could be considered a successful treatment modality for young permanent teeth with oblique root fracture due to the growth of fractured teeth with vital pulp and the maintenance of natural dentition.

Comparative evaluation of retention, marginal adaptation and marginal discoloration of hydrophilic and hydrophobic pit and fissure sealants: A split-mouth randomized controlled trial.

BACKGROUND: Pit and fissure sealants are the most commonly used preventive measure against caries in permanent molars. Advancements in dental materials have led to the development of hydrophilic sealants. However, their clinical efficacy must be evaluated and compared with that of conventional hydrophobic sealants. OBJECTIVES: This study aimed to clinically evaluate and compare the retention, marginal adaptation and marginal discoloration of hydrophilic and hydrophobic pit and fissure sealants over a 12-month follow-up period. MATERIAL AND METHODS: The study was a split-mouth, double-blind, randomized controlled trial. A sample size calculation was performed, and 120 first permanent molars (60 in each group) were selected for inclusion in the study. According to the split-mouth design, the sample was randomly divided into 2 groups. Group A was treated with a hydrophilic sealant (UltraSeal® XT Hydro), while Group B was treated with a hydrophobic sealant (Conseal F). The sealants in both groups were applied in accordance with the manufacturer's instructions by a single operator. The sealants were evaluated clinically using visual and tactile methods by 2 independent examiners who were blinded to the procedure in accordance with the modified United States Public Health Service (USPHS) clinical rating system at placement and at 1, 3, 6, and 12 months. RESULTS: After 12 months of follow-up, the Conseal F sealant showed significantly better retention (p = 0.001), marginal adaptation (p = 0.023) and reduced marginal discoloration (p = 0.004) in comparison to the UltraSeal XT Hydro sealant. CONCLUSIONS: The Conseal F (hydrophobic) sealant demonstrated superior retention, marginal adaptation and marginal discoloration compared to the UltraSeal XT Hydro (hydrophilic) sealant.

Relationship of dietary nutrients with early childhood caries and caries activity among children aged 3-5 years-a cross-sectional study.

BACKGROUND: Early childhood caries (ECC) is a challenge for pediatric dentists all over the world, and dietary factor is an important factor affecting the occurrence of ECC. Currently, there is limited research on the impact of dietary nutrient intake from Chinese diets on ECC. The purpose of this study is to explore the correlation of dietary nutrients intake with ECC and caries activity (CA) among children aged 3-5 years, and to provide dietary guidance to slow down the occurrence and development of ECC. METHODS: A cross-sectional study was conducted in 2022. A total of 155 children were divided into three groups: caries-free group, ECC group and Severe early childhood caries (SECC) group according to the caries statues. And according to the caries activity test (CAT) value, they were also divided into three group: low CA group (L-CA), middle CA group (M-CA) and high CA group (H-CA). The 24-hour dietary intake information was collected by mobile phone application (APP). The intake of children's daily dietary nutrients were calculated referring to "China Food Composition Tables". RESULTS: In this study, 17, 39,and 99 children were diagnosed with caries-free, ECC, and SECC. There were 33, 36, and 86 children diagnosed with L-CA, M-CA, and H-CA. The risk of ECC was increased with the intake of cholesterol(OR = 1.005) and magnesium (OR = 1.026) and decreased with the intake of iron (OR = 0.770). The risk of SECC was increased with the intake of cholesterol (OR = 1.003). The risk of high CA was increased with the intake of cholesterol (OR = 1.002). The combined application of dietary total calories, carbohydrate, cholesterol, sodium, magnesium and selenium in the diagnosis of ECC had an area under ROC curve of 0.741. CONCLUSIONS: The increased dietary cholesterol intake may be a common risk factor for ECC and high CA in children aged 3-5. The combined application of dietary intake of total calories, carbohydrate, cholesterol, sodium, magnesium and selenium has a higher predictive value for the occurrence of ECC.

Advances in hybridized nanoarchitectures for improved oro-dental health.

On a global note, oral health plays a critical role in improving the overall human health. In this vein, dental-related issues with dentin exposure often facilitate the risk of developing various oral-related diseases in gums and teeth. Several oral-based ailments include gums-associated (gingivitis or periodontitis), tooth-based (dental caries, root infection, enamel erosion, and edentulous or total tooth loss), as well as miscellaneous diseases in the buccal or oral cavity (bad breath, mouth sores, and oral cancer). Although established conventional treatment modalities have been available to improve oral health, these therapeutic options suffer from several limitations, such as fail to eradicate bacterial biofilms, deprived regeneration of dental pulp cells, and poor remineralization of teeth, resulting in dental emergencies. To this end, the advent of nanotechnology has resulted in the development of various innovative nanoarchitectured composites from diverse sources. This review presents a comprehensive overview of different nanoarchitectured composites for improving overall oral health. Initially, we emphasize various oral-related diseases, providing detailed pathological circumstances and their effects on human health along with deficiencies of the conventional therapeutic modalities. Further, the importance of various nanostructured components is emphasized, highlighting their predominant actions in solving crucial dental issues, such as anti-bacterial, remineralization, and tissue regeneration abilities. In addition to an emphasis on the synthesis of different nanostructures, various nano-therapeutic solutions from diverse sources are discussed, including natural (plant, animal, and marine)-based components and other synthetic (organic- and inorganic-) architectures, as well as their composites for improving oral health. Finally, we summarize the article with an interesting outlook on overcoming the challenges of translating these innovative platforms to clinics.

Association between high birth weight and dental caries at 4-5 years of age: a birth-cohort study.

OBJECTIVE: Early childhood caries has become a globally crucial oral health problem over the decades. Most studies have discussed the association between low birth weight and early childhood caries; however, studies focusing on high birth weight have been relatively limited. This study aimed to assess the impact of high birth weight on the incidence and severity of dental caries in 4-5-year-old children. SUBJECTS AND METHODS: Study subjects included 491 children from a birth cohort study at 4-5 years of age. Data on dental caries, prenatal and perinatal factors, and socio-demographic determinants were recorded. Logistic regression models adjusted for potential confounders were performed to analyze the data. Two-sided P-value < 0.05 was considered statistically significant. RESULTS: Of the 491 children, the prevalence of dental caries was 48.7%. High birth weight (≥ 4,000 g) was significantly associated with increased incidence of dental caries (OR, 2.000; CI 95% 1.062-3.765), and the relatively enhanced risk OR was further increased in subjects experiencing caries (dmft ≥ 3) (OR, 2.437; CI 95% 1.306-4.549) compared with the normal birth weight (2,500-3,999 g). CONCLUSIONS: High birth weight is a risk factor for early childhood caries. Particular attention should be paid to children with birth weight more than or equal to 4,000 g.

Do SOD2 and SOD3 gene polymorphisms impact the oral health-related quality of life in Para athletes?

The aim of this study was to evaluate whether polymorphisms in SOD2 and SOD3 genes modulate the oral health-related quality of life (OHRQoL) of Para athletes with dental caries experience. The cross-sectional study included 264 Para athletes (143 in athletics, 61 in weightlifting and 60 in swimming). A trained and calibrated team recorded the decayed, missing and filled teeth index (DMFT). The Brazilian version of the Oral Health Impact Profile (OHIP-14) was used to measure OHRQoL. Genomic DNA was extracted from the athletes' saliva, and genetic polymorphisms in the SOD2 (rs5746136 and rs10370) and SOD3 (rs2855262 and rs13306703) genes were analyzed by real-time polymerase chain reaction. Univariate and multivariate analyses were performed. A multivariate General Linear Model analysis, adjusted for sex, revealed that the SOD3 gene polymorphism (rs2855262) had a significant effect on the psychological disability domain [codominant (p = 0.045) and recessive (p=0.038) models]. The SOD2 gene polymorphism (rs5746136) had a significant effect on the total OHIP-14 score [dominant model (p = 0.038)] and the psychological discomfort [dominant model (p = 0.034)] and physical disability [codominant model (p=0.037)] domains. Presence of the SOD2 rs10370 polymorphism led to statistical differences in the total score [codominant (p = 0.026) and dominant (p = 0.023) models] and the handicap domain scores [codominant (p = 0.027) and dominant (p = 0.032) models]. Polymorphisms of the SOD2 and SOD3 genes may be important biomarkers of OHRQoL in Para athletes with dental caries experience.

Estimated Carbon Emissions Associated With Dental Treatment For Early Childhood Caries.

Purpose: The purpose of this study was to evaluate the environmental impact of travel and anesthetic gas emissions associated with treating early childhood caries at a single institution. Methods: Outpatient preventive, treatment, and modeled general anesthesia (GA) cases in children 71 months old and younger were included in this retrospective chart review. The main outcomes were kilograms of carbon dioxide equivalents (kgCO2e) for travel- and anesthetic gas-related emissions. Descriptive statistics and non-parametric tests were used. Results: Most subjects had a caries treatment visit (n equals 3,630 out of 5,767), and nine percent of treatment visits (n equals 353 out of 3,630) received nitrous oxide (N2O), which added 29.4 kgCO2eto the visit emissions. Children without caries treatment had lower travel-related emissions (median equals 7.5 kgCO2e; interquartile range [IQR] equals 7.6) than children with caries treatment (median without N2O equals 8.7 kgCO2e; IQR equals 18.2; median with N2O equals 8.4 kgCO2e; IQR equals 10.3). Modeled GA travel emissions were estimated at 16.4 kgCO2e (IQR equals 21.9) with between 3.8-12.9 kgCO2e in anesthetic gas emissions. Total emissions were greatest for N2O treatment visits (median equals 43.3 kgCO2e; IQR equals 22.8). Conclusions: Travel-related emissions were greatest for children requiring caries treatment. Minimizing patient travel may reduce environmental impact. Nitrous oxide contributes a significant amount to a dental visit???s environmental impact. Community-focused models of care and applying systematic and practical case selection to reduce excess N2O emissions could reduce dental care-related carbon emissions.

Cariogenicity and Calories of Meals Served at a Pre-Kindergarten School-Based Meal Program.

Purpose: To analyze the cariogenicity of meals served in a pre-kindergarten program and its potential influence on early childhood caries (ECC) risk in socioeconomically disadvantaged children. Methods: This study examined 123 school-provided meals over 43 days at the United Nation Childhood Development Center, part of the Oakland Unified School District pre-kindergarten program. Using cariogenicity indices developed by Evans et al., all items served were assessed for the cariogenic potential of both food and beverages. Results: The mean daily cariogenicity scores were 6.57±1.3 (standard deviation) for food and 2.89±0.78 for beverages. Breakfast foods were significantly more cariogenic than those served for lunch or supper (P<0.05). The mean daily calorie intake was 1,459±336, with lunch containing statistically higher calorie items compared to supper (P<0.05). While liquids may not significantly contribute to caries risk, breakfast foods emerged as a potential concern. Conclusions: This study's findings suggest that the food provided in school meals, particularly breakfast items, may impact early childhood caries risk among socioeconomically disadvantaged children. Given the prevalence of ECC and its societal burden, integrating assessments of food and beverage cariogenicity into school meal planning could be instrumental in mitigating ECC incidence. Collaboration between the United States Department of Agriculture and school districts in considering the cariogenic potential of foods may contribute to improved oral health outcomes in early childhood.

Efficacy of American Academy of Pediatric Dentistry Best Practice Recommendations for Diagnosis and Management of Deep Caries in Primary Teeth.

Purpose: To evaluate the efficacy of the American Academy of Pediatric Dentistry (AAPD) best practice recommendations for the diagnosis and management of deep carious lesions in primary teeth. Methods: Primary molars from four to eight-year-old children were selected for diagnosis and treatment planning independently by a pediatric dental resident using the AAPD recommendations and a pediatric dentist using his clinical expertise and experience. The analysis of the two evaluators was performed for sensitivity, specificity, positive predictive value, negative predictive values, and agreement scores. Results: A total of 365 primary molars from 185 children were used. Diagnosis and treatment planning by the resident demonstrated a higher sensitivity score of 92.7 percent (95 percent confidence interval [95% CI]=80.1 to 98.5) and specificity score of 96.6 percent (95% CI=94 to 98.3) for treatment planning compared to a diagnosis having sensitivity and specificity scores of 74 percent (95% CI=59.7 to 85.4) and 89.8 percent (95% CI=86 to 92.9), respectively. Lower agreement scores between the resident and the pediatric dentist were found for the diagnosis of asymptomatic irreversible pulpitis and the use of lesion sterilization and tissue repair as a treatment modality. Conclusions: The AAPD best practice recommendations showed a better consistency for treatment planning than the diagnosis of carious primary molars.

An investigation of the association between parenting style and child's dental caries: a cross-sectional study.

To investigate the association between parenting style and child's dental caries. Parents presenting with their children to the Department of Pediatric Dentistry at Tufts University School of Dental Medicine for an initial exam or re-care appointment completed a demographic survey and the parenting styles and dimensions questionnaire. Recruitment of subjects started in May 2019 and ended in February of 2020. Child's decayed, missing, and filled teeth (dmft) index, diet score, sex, and age were recorded, as were parent's race, education level, and form of payment. Adjustment for confounders was done using multivariable negative binomial regression. The sample size was 210 parent/child dyads. In the multivariable analysis, parenting style and child's dmft were not significantly associated (p > 0.05). Parents with an education level less than high school (p = 0.02) and at the high school graduate level (p = 0.008) were significantly associated with children who had higher dmft, compared to parents with a college degree or higher. Children with excellent diet scores had significantly lower dmft than children with a diet score in the "needs improvement" category (p = 0.003). There was no significant evidence that parenting style is associated with child's dental caries. Parent's education level and child's diet score were significantly associated with child's dmft, less than high school (p = 0.02) and at the level of high school graduate (p = 0.008). Pediatric dental professionals should be aware of these risk indicators.

[Comparative assessment of the intensity of caries among dental patients of older age groups in need of removable prosthetics, registered by a phthisiatician and their perception of an artificial ageist situation.]

Improving the quality of life of older age groups is an urgent problem of medicine, including its components: gerontology, phthisiology and dentistry. The objectives of the study are: to establish the importance of tuberculosis as an infection that causes the intensity of caries among patients of older age groups; assessment using the Palmore scale of gerontological ageism «The ageism survey¼ and patients' perception of an artificial situation of age inequality. The study involved elderly (n=122) and senile (n=121) persons with partial secondary adentia who needed removable dentures. The control groups of older people included patients who denied being under the supervision of a phthisiologist, and the study groups confirmed this. To solve the first problem, a comparative assessment of the values of the components of the CPI index in the control and study groups was carried out. To solve the second problem, an artificial situation of age inequality was simulated in the process of dental admission. The results of its effects were evaluated based on the response of patients to questions № 9, 10 of the Palmor scale. The absence of a difference in the values of K and N components between the control and study groups indicates the absence of a significant effect of mycobacteria on the development of caries. The large values of component Y in the studied groups may indicate the detrimental effect of mycobacteria on periodontal disease. The absence of an increase in the intensity and stability of the perception of age inequality among patients who are under the influence of an artificially created situation proves the great effectiveness of background age inequality. At the same time, it is impossible to exclude the low sensitivity of the Palmor scale in the process of diagnosing age inequality in Russian society.

Oral hygiene status and vascular aging in schoolchildren and their mothers.

BACKGROUND: Poor oral hygiene, generally manifesting as dental caries, gingivitis, or periodontitis, is a common chronic condition among both children and adults worldwide and has been reportedly associated with hypertension and arterial stiffness mainly in adult patients. However, these associations have not been well-studied in children and adults in the general population. Therefore, we conducted this cross-sectional study to clarify the associations between oral hygiene indices and high blood pressure (BP)/hypertension and arterial stiffness as assessed by the cardio-ankle vascular index (CAVI) in children along with their mothers. The association between maternal oral hygiene and high BP in children was also examined based on the hypothesis that maternal awareness of oral hygiene is related to their children's oral hygiene. METHODS: This study was conducted as an Adjunct Study of the Aichi Regional Sub-Cohort of the Japan Environment and Children's Study. Participating children (n = 220, 85-104 months old) and their mothers (n = 217, 29-52 years old) underwent dental/intra-oral examination and BP and CAVI assessment. High BP in children and hypertension in mothers were diagnosed according to corresponding American guidelines. Logistic regression analysis or analysis of covariance was used to examine the associations of poor oral hygiene indices with BP and CAVI. RESULTS: Maternal dental caries ≥1 was associated with their hypertension (adjusted odds ratio [aOR]: 2.72, 95% confidence interval (CI): 1.12-6.61). Maternal dental plaque ≥1/3 was associated with maternal hypertension and children's high BP (aOR, 95% CI: 4.71, 1.33-16.73 and 5.67, 1.22-25.04, respectively). Maximum pocket depth ≥4 mm was associated with children's high BP (aOR: 6.85, 95% CI: 1.24-38.01). No associations were observed between oral hygiene indices and CAVI in children; however, there was a significant association between dental plaque and CAVI in mothers (F = 5.62, p < 0.01). CONCLUSIONS: The small sample size, especially the case number, made it necessary to refrain from drawing unambiguous conclusion. The hypothesis that warrants further investigation based on the present study results is that poor oral hygiene is associated with high BP in children and hypertension and arterial stiffness in mothers, and maternal oral hygiene is associated with high BP in children.

Utilization of Dental Care and Oral Health Outcomes in the United States: Results from the National Health and Nutrition Examination Survey (2017-2020).

PURPOSE: This analysis aims to evaluate the association between the time since and reason for a patient's last dental appointment across clinical oral health outcomes. MATERIALS AND METHODS: We used data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES), a cross-sectional, nationally-representative survey of noninstitutionalized US adults. The predictors were the time since and the reason for the last dental appointment (routine vs. urgent). We examined the presence and number of missing teeth and teeth with untreated coronal and root caries. Multivariable regression models with interaction were used to assess the association between the time since the last dental appointment and clinical oral health outcomes among routine and urgent users separately. RESULTS: Two-thirds of the US population had a dental appointment within a year, while nearly 44 million individuals did not visit a dentist for the last three years. The odds of having teeth with untreated coronal or root caries increased with the length of time since the last appointment, and urgent users had worse dental outcomes compared to routine users. Compared to those who had a dental appointment within a year, individuals who had their last dental appointment more than 3 years ago had 2.94 times the average number of teeth with untreated caries among routine users (95%CI=2.39, 3.62) and 1.60 times the average among urgent users (95%CI=1.05, 2.43). CONCLUSIONS: Recent, routine dental appointments are associated with improved oral health outcomes. The outcomes reiterate how social determinants of health impact access to oral health care and oral health outcomes.